Lei Song1, Hong Qiu1, Yuan Wu1, Jun Zhang1, Yin Zhang1, Xiao-yan Tan1, Shu-bin Qiao1, Yong-jian Wu1, Hong-bing Yan1, Run-lin Gao1, Zai-jia Chen1, Yue-jin Yang2. 1. Coronary Heart Disease Center, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College,National Center for Cardiovascular Disease, Beijing 100037, China. 2. Coronary Heart Disease Center, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College,National Center for Cardiovascular Disease, Beijing 100037, China. Email:yangyjfw@yahoo.com.cn.
Abstract
OBJECTIVE: To evaluate the gender differences on the short-term outcomes of patients with acute myocardial infarction in the real world. METHODS: A total of 471 consecutive patients [male 368(78.1%) and female 103(21.9%)] with acute myocardial infarction <72 hours in cardiac care unit were included. The clinical data, death and major adverse cardiac and cerebrovascular events at 30 days post hospitalization were analyzed. RESULTS: Female patients were older (66.8 ± 10.1 vs. 56.9 ± 12.0, P < 0.001), TIMI score (5.1 ± 2.3 vs. 3.9 ± 2.1, P < 0.001) and GRACE score (162 ± 39 vs. 142 ± 35, P < 0.001) in female patients were higher than in male patients. Female patients had lower proportion of stent implantation (P = 0.038) while higher percentage of complex lesions and contraindications to PCI (P = 0.015) compared to male patients. Proportion of cardiac rupture, mitral regurgitation, malignant arrhythmia, post-infarction angina pectoris, contrast-induced nephropathy and minor gastrointestinal bleeding were also higher in female patients tan in male patients (P < 0.05). Thirty-day mortality was significantly higher in female patients than in male patients [5.8% (6/103) vs. 1.9% (7/368), P = 0.032], MACCE [10.7% (11/103) vs. 5.4% (20/368), P = 0.058] also tended to be higher in female patients than in male patients. Multi-logistic regression analysis showed that female gender was not an independent predictor for thirty-day mortality (P = 0.141) or MACCE (P = 0.426) while systolic blood pressure (OR = 1.072, 95%CI:1.016-1.130, P = 0.010) and pericardial effusion after myocardial infarction (OR = 40.518, 95%CI:1.098-1495.702, P = 0.044) were independent predictors for thirty-day mortality while systolic blood pressure (OR = 1.027, 95%CI:1.002-1.052, P = 0.036) and left ventricular ejection fraction (OR = 1.108, 95%CI:1.032-1.190, P = 0.005) were independent predictors for MACCE. CONCLUSIONS: Female gender itself is not an independent predictor for thirty-day mortality and MACCE despite poorer clinical characteristics, higher incidence of complications, and worse prognosis in female patients.
OBJECTIVE: To evaluate the gender differences on the short-term outcomes of patients with acute myocardial infarction in the real world. METHODS: A total of 471 consecutive patients [male 368(78.1%) and female 103(21.9%)] with acute myocardial infarction <72 hours in cardiac care unit were included. The clinical data, death and major adverse cardiac and cerebrovascular events at 30 days post hospitalization were analyzed. RESULTS: Female patients were older (66.8 ± 10.1 vs. 56.9 ± 12.0, P < 0.001), TIMI score (5.1 ± 2.3 vs. 3.9 ± 2.1, P < 0.001) and GRACE score (162 ± 39 vs. 142 ± 35, P < 0.001) in female patients were higher than in male patients. Female patients had lower proportion of stent implantation (P = 0.038) while higher percentage of complex lesions and contraindications to PCI (P = 0.015) compared to male patients. Proportion of cardiac rupture, mitral regurgitation, malignant arrhythmia, post-infarction angina pectoris, contrast-induced nephropathy and minor gastrointestinal bleeding were also higher in female patients tan in male patients (P < 0.05). Thirty-day mortality was significantly higher in female patients than in male patients [5.8% (6/103) vs. 1.9% (7/368), P = 0.032], MACCE [10.7% (11/103) vs. 5.4% (20/368), P = 0.058] also tended to be higher in female patients than in male patients. Multi-logistic regression analysis showed that female gender was not an independent predictor for thirty-day mortality (P = 0.141) or MACCE (P = 0.426) while systolic blood pressure (OR = 1.072, 95%CI:1.016-1.130, P = 0.010) and pericardial effusion after myocardial infarction (OR = 40.518, 95%CI:1.098-1495.702, P = 0.044) were independent predictors for thirty-day mortality while systolic blood pressure (OR = 1.027, 95%CI:1.002-1.052, P = 0.036) and left ventricular ejection fraction (OR = 1.108, 95%CI:1.032-1.190, P = 0.005) were independent predictors for MACCE. CONCLUSIONS: Female gender itself is not an independent predictor for thirty-day mortality and MACCE despite poorer clinical characteristics, higher incidence of complications, and worse prognosis in female patients.